Cultural conceptualizations of rapport in assistive technology implementation for elder care: An integrative review

This integrative review examines how culturally embedded conceptualizations of rapport influence assistive technology implementation in elder care across diverse global contexts. Through systematic analysis of 76 studies spanning seven major cultural regions, the review reveals that rapport operates as a fundamental mediator of technological acceptance, manifesting through distinct cultural constructs: filial piety frameworks (xiao, hyo, amae) in East Asia; seva and Saṅgha in South Asia; karam in Arab/Muslim societies; Ubuntu in Sub-Saharan Africa; whānau and Two-Eyed Seeing in Indigenous contexts; familismo and personalismo in Latin America/Hispanic societies; and autonomy-based trust in Western societies. Cross-cultural analysis using Hofstede's framework reveals systematic patterns: high power distance cultures embed AT within hierarchical obligations, collectivist societies require technologies to support extended networks, and uncertainty avoidance influences openness to unfamiliar devices. The review demonstrates that AT implementation outcomes vary significantly based on cultural rapport conceptualizations, with technologies achieving higher adoption when aligned with existing relational frameworks rather than attempting to replace traditional care values. These findings challenge universal technology acceptance models and suggest the need for culturally specific implementation strategies that honor diverse rapport conceptualizations while addressing practical care needs in aging populations worldwide.